Healthcare Provider Details

I. General information

NPI: 1073107199
Provider Name (Legal Business Name): AURORA HOBART
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2021
Last Update Date: 03/01/2021
Certification Date: 03/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 W MAIN ST
MERCED CA
95340-4521
US

IV. Provider business mailing address

1020 W MAIN ST
MERCED CA
95340-4521
US

V. Phone/Fax

Practice location:
  • Phone: 209-695-8259
  • Fax:
Mailing address:
  • Phone: 209-695-8259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: